Diabetes Mellitus Specialty Group Overview

Diabetes Mellitus Specialty Group providers care and treat patients with all aspects of diabetes including:

Intensive insulin therapy

Hypoglycemia in patients with diabetes and in people without diabetes

Pregnancy

Nutritional management

Exercise education

Complication prevention

Lipid management

Ophthalmologic monitoring

Neuropathy management

Behavior modification

Diabetes Center for Intensive Insulin Therapy in Minnesota

Mayo Clinic offers a structured, three-day outpatient class for intensive insulin therapy called the "Diabetes Unit." Intensive insulin therapy is a mode of treatment in which the primary goal is to keep blood sugars as near normal as possible. The Diabetes Control and Complications Trial showed that tight blood sugar control prevents or slows the progressive complications of diabetes that affect the eyes, kidneys and nerves.

Intensive insulin therapy attempts to mimic a normal pancreas by using two types of insulin: long-acting (basal) insulin and rapid-acting (bolus) insulin. Rapid-acting insulin is taken specifically to cover food eaten. Brief highlights of the class:

Day 1

Introduction to the intensive insulin program, concepts of dose adjustment and correctional boluses

Introduction to the intensive insulin program and hypoglycemia treatment

Day 2

Day 3

Arrangements for admission to the "Diabetes Unit" class can be made following a consultation with a Mayo Clinic endocrinologist

Education through the Diabetes Unit helps patients use insulin pumps in a more informed manner.

Diabetes Technology Clinic

Mayo Clinic offers education about insulin pump therapy. An insulin pump is a device the size of a pager that contains a syringe reservoir filled with insulin. A small flexible tube connects the reservoir of insulin to a catheter inserted under the skin in the abdomen. The pump releases rapid-acting insulin and delivers insulin in two ways: continuously (basal) and in bursts (bolus), to cover food eaten. An insulin dose is manually programed into the pump to cover food eaten.

Education includes:

Review

Insulin pump therapy and hypoglycemia

Insulin sensitivity factor and correctional bolus

Adjustment of basal rate and bolus insulin

Exercise and insulin pump therapy

Carbohydrate counting review

Insulin to carb ratios

Mayo Clinic has had a Diabetes Technology Clinic since 2005. This unique clinic evaluated patients interested in using diabetes technologies and provides periodic follow-up. Patients who need more-advanced systems such as continuous glucose sensor augmented insulin pumps and closed loop sensor insulin pump systems are identified and their approval for such technologies facilitated. The program also conducts clinical trials to advance continuous glucose monitoring, insulin pumps and closed loop systems.

Continuous glucose monitoring (CGM) systems: Mayo Clinic offers CGM as a procedure. Mayo caregivers have used Medtronic and Dexcom CGM as a service since 2006. More recently, caregivers have begun using Abbott Libre CGM. Currently, Mayo Clinic caregivers perform about 70 CGMs annually.

Diabetes Education Program

Referral to the program is arranged by a Mayo Clinic physician who will first evaluate the patient's diabetes and related need for education. An endocrinologist may evaluate some patients, and a nurse specializing in diabetes may assist the endocrinologist with others.

The diabetes education program is based upon an individualized assessment of the patient's learning needs. Therefore, the length of time required for education varies. An individualized education plan is developed by the diabetes educator in collaboration with the patient.

Using one-to-one teaching or group classes supplemented with audiovisual and printed materials, nurse and dietitian diabetes educators provide instruction as needed in program content areas relating to:

Diabetes and pregnancy

The outcome of a diabetic pregnancy now approaches the nondiabetic state when the patient is properly managed by an obstetric and endocrinology team. For nearly 20 years, Mayo has utilized a multidisciplinary approach to the care of patients with gestational diabetes, working with high-risk obstetricians in the Maternal Fetal Medicine Specialty Group.

This multidisciplinary team manages patients as their primary physician or in consultation with the referring physician. Arrangements for consultations with the team can be made through the patient's physician in obstetrics or your primary provider. Patients with type 1 diabetes may be seen by advanced practice providers embedded in the Maternal Fetal Medicine specialty group. Such patients are enrolled in Mayo clinical research protocols to optimize insulin therapy between visits through remote contact.

A single copy of these materials may be reprinted for noncommercial personal use only. "Mayo," "Mayo Clinic," "MayoClinic.org," "Mayo Clinic Healthy Living," and the triple-shield Mayo Clinic logo are trademarks of Mayo Foundation for Medical Education and Research.